1. Field of the Invention
The present invention generally relates to data processing systems, and more particularly relates to systems and methods for providing quality assurance in data processing cycles.
2. Related Art
A conventional data processing cycle involves a considerable amount of manual intervention. For example, the revenue cycle involves a considerable amount of manual billing and is very labor intensive and therefore costly and also significantly more prone to human error. Incorrect data are entered during the conventional data processing cycle due to human errors (e.g. typo), lack of knowledge (e.g. data entry person did not realize that the data entered would violate clause in the contract), and other reasons. These data error will cost more time, money and human resources if the errors are not corrected before being transmitted to the data recipient (could be a person or a system). In the healthcare revenue cycle the manifestation would be a claim denied by a payer, which results in rework on the claim by the hospital's billing department, re-transmission of the claim and review of the reworked claim by the payer before the hospital can receive the reimbursement from the payer. The delay in collection period, the time it took to deny a claim, request for rebill, and review the reworked claim cost both the data sender and the data recipient more time and money to complete the data processing.
These significant problems with the conventional data processing cycle have created a need in the industry for improved systems and methods that overcome the problems described above.